*Please fill out the application to the best of your ability. All responses are confidential, and some questions may require input from your guardian.

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* 1. Name

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* 2. Address

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* 3. Phone Number

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* 4. Email

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* 5. Are you applying for SYEP?

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* 6. Gender Identification (Please check all that apply)

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* 7. Next year grade

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* 8. I attend a public school in New York City

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* 9. My school is in the following borough of NYC

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* 10. Does your High School have a school newspaper?

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* 11. How do you identify for race? (check all that apply):

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* 12. Please check all that apply

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* 13. Household Income(Please check one):

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* 14. Parents/Guardians' Educational Attainment (Please check all that apply):

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* 15. How many people live in your household? (Please check one)

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* 16. I live in NYCHA/Public Housing

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* 17. Have you or your family ever been impacted by any of these systems? (select all that apply)

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* 18. Report Card Sharing

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* 19. Essay Submission

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
Choose File

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* 20. I can commit to attending a 6-week program that meets in mid-town Manhattan Mondays-Thursdays from 10:00 am – 4:00 pm with at-home assignments on Fridays.

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